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As hackers ramp up attacks on hospitals and health systems, labs face a new wave of cybersecurity preparation

If you work in a clinical laboratory, you are a guardian of valuable data. At your fingertips, you likely have access to patients’ Social Security numbers, demographic information, and sensitive medical test results. Even if the data you deal with on a day-to-day basis feels routine—and the security protocols from your information technology (IT) department seem like a hassle—the threat of hackers breaching laboratory information systems is a real and growing one, according to experts.

“If you connect to the internet, you’re not safe,” said David Finn, the healthcare IT officer of Symantec, a large enterprise cybersecurity company. “So the belief that your systems are safe because you operate in a rural area, or you don’t have celebrity patients, or your facility is not an academic institution just isn’t true.”

Imagine the consequences if all your lab’s data—past and present—were posted in the public realm. Consider what would happen to the flow of patient care if you couldn’t access your lab’s computers or databases for days on end. “If a lab gets shut down, you’ve now impacted all the operations of a hospital,” Finn said. “Obviously there are patient care consequences in that.”

However, that worst-case scenario is often avoidable. By being aware of cybersecurity best practices, taking steps to protect data, and having back-up plans in place, laboratories can fend off cybersecurity threats.

A Treasure Trove for Hackers

Historically, hackers looking to infiltrate databases of personal information have pursued the networks of banks and credit card companies. But, thanks to better security tactics by those industries over the past decade, many hackers are starting to shift their focus.

“Healthcare hasn’t been as robust in its security as other industries,” said Marti Arvin, the vice president of audit strategy at CynergisTek, a healthcare security consulting firm. “As a result, we’re now seeing hacks and threats aimed at healthcare that you might not see in the financial sector or credit card industry.”

In 2015, more than 113 million health records were compromised, according to the Department of Health and Human Services Office of Civil Rights. Hackers breached the personal information of tens of millions of customers of the health insurers Anthem and Premera Blue Cross. In early 2016, hackers infected the networks of a handful of hospitals and broader health systems across the country with ransomware, malicious programs that hold patient records hostage and enable the hackers to demand a ransom to return them. The persistence of cyberattacks on hospital networks now makes healthcare the most frequently attacked industry, beating out the financial and retail sectors, and costing the industry $5–6 billion a year.

“We have all the best data that the bad guys want because we collect so much information about patients,” Finn said. “Their demographic information alone would be good enough to start doing some bad things, but then you add data like credit card numbers, insurance account numbers, and Social Security numbers, and it really is one-stop shopping for them.”

Even more concerning, as foreign governments increasingly turn to cyber-espionage to gain intelligence about the United States, hackers gain new sources of funding. “Sometimes espionage is all about socioeconomic gathering,” said Mac McMillan, the CEO and co-founder of CynergisTek. “There’s nothing more lucrative to a foreign government than gathering that kind of information about the health of our population.”

Labs at Risk

Increasingly, hackers penetrate hospital networks by infecting medical devices with their malware and ransomware, using out-of-date instruments as holes in the system. This tactic adds a new kind of threat beyond the better known use of emails or clickbait to infiltrate servers. “In 2015, we saw an awful lot of cardiology intervention centers and catheterization labs get shut down because of malware,” said Finn. “The year before, we saw the medication cabinets in nursing areas get infected.”

Labs—like cardiology centers, nursing stations, and pharmacies—often have their own record systems, devices, and IT support that operate independently of the broader hospital or healthcare system. In IT, these silos pose particular risks. For example, when information passes between silos, it often presents a weak spot for hackers to access. Moreover, devices run within silos might not receive enough attention from IT professionals compared to the main systems.

“We have the whole range of threats that other industries have, but we have other challenges as well,” said David Robb, manager of laboratory information systems at Sutter Health in Palo Alto, California. “Lab instruments have all sorts of vulnerabilities, often because of the fact that they’re not always kept up to date the way the main system is.” The type, and extent, of information that labs possess also makes them a prime target—a clinical lab could have hundreds of test results for each patient.

Protecting Labs Against Cyber Threats

How can laboratories protect sensitive information? Experts suggest a handful of steps leaders should take to keep data secure and to plan for how to keep labs running smoothly in the case of a breach (open figure). At the same time, cybersecurity may also require the help of outside experts. Arvin and McMillan at CynergisTek recommend hiring consultants to take a look at security, even if staff feel like they are on top of everything. “You often miss things in house, because you’re so familiar with the environment,” said Arvin. “And beyond that, when leadership hears something from the outside, they tend to take it more seriously.”

Labs might also take advantage of information from the Centers for Disease Control and Prevention, which recently released a discussion guide for healthcare cybersecurity which includes a number of drills and scenarios to help get organized. The guide is available at www.cdc.gov/phpr.

Finally, laboratory leaders must ensure that all staff participate in cyber breach preparation drills, Robb emphasized. “Labs have to be involved in planning,” he said. “It can’t just be an IT thing where they’re doing drills in a closet somewhere. Laboratory staff have to understand what the procedures are and how to prepare for any downtime.”